February 2015

Emerging Infectious Diseases Journal

Highlights: Emerging Infectious Diseases, Vol. 21, No. 2, (February 2015)

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1. Simulation Study of the Effect of Influenza and Influenza Vaccination on Risk of Acquiring Guillain-Barré Syndrome, Steven Hawken et al.

Having influenza slightly increases a person’s risk of getting Guillain-Barré syndrome (GBS), a rare disorder in which the patient’s own immune system attacks part of the nervous system, usually resulting in partial paralysis and in some cases death.  Influenza vaccination has been implicated as one of many possible risk factors for GBS, although whether it increases or decreases risk is under debate. To help answer this question, researchers used mathematical modeling to simulate risk scenarios. Results indicated that under typical influenza conditions (incidence rates >5% and vaccine effectiveness >60%), influenza vaccination reduces risk for GBS. These findings should strengthen confidence in the safety of influenza vaccine and enable health professionals to better put GBS risk in context when discussing influenza vaccination with patients.

Contact Dr. Kumanan Wilson via:
Paddy Moore
Communications and Public Relations
Ottawa Hospital Research Institute, Ottawa Ontario, Canada
padmoore@ohri.ca
613-737-8899 ext. 73687

2. Awareness and Support of Release of Genetically Modified “Sterile” Mosquitoes, Key West, Florida, USA, Kacey C. Ernst et al.

Novel public health strategies require community engagement; however, the scientific community is divided over how much information should be provided to community members. An example occurred in Key West, Florida, after the 2009–2010 outbreak of dengue fever, when a proposed mosquito control strategy was met with some controversy within the community. The proposed strategy involves the release of predominantly male mosquitoes genetically modified to produce nonviable offspring, ultimately reducing the overall mosquito population. Results of a survey revealed that despite outreach and media attention, only half of the survey population was aware of the proposal; and among those aware of the proposal, more than half supported the proposal and slightly less than one-fifth were opposed. Researchers concluded that solutions should include input from stakeholders, the public and community leaders; should be made transparent through public events, articles, and presentations; should target groups who tend to be less aware of public health measures; and should include those in adjacent areas because residents and mosquitoes are mobile.

Contact:
Kacey C. Ernst
University of Arizona College of Public Health, Division of Epidemiology and Biostatistics kernst@email.arizona.edu

3. Melioidosis Diagnostic Workshop, 2013, Alex R. Hoffmaster et al. 

Melioidosis is a severe disease and a potential bioterrorism threat. Diagnosis is difficult because symptoms are varied and no reliable rapid diagnostic tests are commercially available. With the goal of improving timely and accurate melioidosis diagnosis, a workshop was held in Bangkok, Thailand, on September 14–15, 2013. Attendees identified common misconceptions and pitfalls associated with diagnosis. They described the ideal rapid test as using inexpensive commonly available supplies, requiring minimal training, being accurate under a variety of laboratory conditions, and having a long expiration date. They concluded that patients suspected of having melioidosis should immediately be given appropriate antibiotics, without waiting for diagnosis. They also concluded that diagnostic efforts should include culture of all available specimens on selective media; that existing rapid tests (e.g., latex agglutination) should be made available, particularly in low-resource areas; and that most useful would be simple point-of-care tests (e.g., lateral flow immunoassays), which might become available in the near future. Such testing capacities would greatly aid rapid diagnosis and reduce melioidosis-related deaths in developed countries and low-resource settings.

Contact Alex R. Hoffmaster via:
CDC Press Office
404-639-3286
media@cdc.gov

4. Zoonotic Transmission of Toxigenic Corynebacterium ulcerans Strain, Germany, 2012, Dominik M. Meinel et al.  

Several types of corynebacteria produce diphtheria toxin, which can lead to life-threatening disease. One type, C. ulcerans, has been isolated from domestic animals such as pet dogs and cats, and spread from pets to humans (zoonotic transmission) has been suspected. Evidence of such spread, however, has relied on poorly reproducible methods that depend on subjective interpretation. Recently, however, a technique called next-generation sequencing was used to clearly prove dog-to-human spread of C. ulcerans. The human patient showed symptoms but the dog did not. The next-generation sequencing technique determined that the genetic makeup of bacteria isolated from the dog very closely matched that from its human owner. The cost of next-generation sequencing is declining, and use of this technique should help with future outbreak investigations and should support public health authorities in the management of infectious diseases.

Contact Andreas Sing via:
Press Office
Bavarian Health and Food Safety Authority, Oberschleißheim, Germany
Pressestelle@lgl.bayern.de

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES